Environmental and Occupational Health Sciences Institute
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An Irritable Bowel Syndrome Treatment Protocol for Mental Health: A Program Evaluation
No full textPurpose: This Doctor of Nursing Practice (DNP) project aimed to evaluate the impact of the IBS treatment protocol specifically as it pertained to levels of depression, anxiety, stress, and fatigue.Methods: Program evaluation was completed via secondary data aggregation and analysis and utilized the Context, Input, Process, Product (CIPP) theoretical framework to develop evidence-based recommendations to guide the trajectory of the protocol. Wilcoxon signed-rank tests were conducted to identify changes in primary measures (levels of depression, anxiety, stress, and fatigue) in individuals before and after receiving the 6-week treatment protocol.
Results: Significant improvements were noted in depression, anxiety, stress, and fatigue as well as overall self-reported level of satisfaction with GI health status.
Implications for practice: The results suggest that glutamine supplementation may be a viable treatment approach for functional GI conditions and may also subsequently improve both symptoms of depression and anxiety as well as levels of stress and fatigue. Both medical and psychiatric providers should be mindful of the interrelatedness of GI dysfunction and mental health symptoms and utilize opportunities to implement primary, secondary, and tertiary prevention measures for psychiatric disorders.D.N.P.Includes bibliographical referencesIncludes vit
Improving Colorectal Cancer Screening in the Latino Population: A Quality Improvement Project
No full textAbstractPurpose of Project: This quality improvement project aimed to increase the number of Latino patients receiving a routine colonoscopy at a gastroenterology practice in Passaic County, NJ.
Methods: An in-service training for staff on best practices for educating patients on the importance of colorectal cancer screening was conducted and an updated patient informational packet that had information in English and Spanish was distributed. Secondary data collected from chart reviews was used to measure outcomes. Measures included the number of individuals, 45 years and older, who had a consultation for routine colonoscopy, the number who underwent a colonoscopy, number of patients with colorectal cancer or malignant polypectomy, and the number of patient informational packets distributed.
Results: In the pre-implementation period, 32 people met eligibility criteria and had an office consultation for a colonoscopy. Of those, 13 had a colonoscopy, yielding a CRC screening rate of 40.6%. During the post-implementation period, 30 people were eligible, had an office consultation, and received an informational packet. Of those, 25 had a colonoscopy yielding a screening rate of 83.3%. A Chi-square test was used to assess the difference between the groups with regards to the CRC screening rates (x2 = 11.904, p < 0.001). Based on this result, it suggests that the intervention was successful in improving CRC screening rates within the target population.
Implications: Early colorectal screening screens can prevent colorectal cancers. Use of a culturally tailored educational intervention to increase preventive screening is beneficial. Patient education aligning with Healthy People 2030 objectives to promote and increase personal health literacy for at-risk populations was key and contributed to the success of this project.
Keywords: colonoscopy, colorectal cancer, improvement, interventions, Latino, screeningD.N.P.Includes bibliographical referencesIncludes vit
Earnings and price forecast with time-series and machine learning approaches
No full textThis dissertation consists of two chapters, both of which relate to earnings and stock price forecasting.
In the first chapter, panel VAR models are developed to generate earnings and price forecasts. The first chapter builds upon traditional time-series models to develop a panel VAR model that simultaneously forecasts earnings and prices. The panel VAR forecasting outperforms ARIMA models in price and earnings forecasts. The main reason for this superiority is that the ARIMA model is considered technical analysis, using past prices to predict future prices. On the other hand, the panel VAR model corresponds to models that are regarded as fundamental analysis, incorporating accounting and price variables to predict future performance of both accounting earnings and market prices. Panel VAR models are an extension of ARIMA models, incorporating more variables into the forecasting model. The results demonstrate that panel VAR models are more accurate and generally unbiased compared to analyst forecasts, which often exhibit significant optimistic bias. The current analysis extends the literature on earnings and price forecasts and provides insights into the bias in analyst forecasts.
The second chapter explores the use of XGBoost, LightGBM, and CatBoost machine learning models to predict future earnings, prices, and dividend forecasts. By comparing the machine learning forecast results with consensus analyst earnings and target price forecasts, we demonstrate that machine learning outperforms analyst forecasts based on sign test results. Additionally, by discussing three portfolio investment cases and comparing machine learning investment portfolios with expected returns on market portfolios, investors can earn profits based on machine learning portfolios under five scenarios. In the most promising scenario, following the machine learning portfolios can result in excess profits of $40.91 compared to market portfolios over approximately 15 days. Through the analysis of three different portfolio cases, the results indicate that machine learning performs well in price forecasting when the time-series distribution is stable. However, in highly unstable situations, financial analysts tend to outperform machine learning models.Ph.D.Includes bibliographical reference
Latino until proven innocent: navigating crimmigration in U.S. immigration courts
No full textI explore how law and legal bureaucracies create and reproduce ethnic and racial inequalities via immigration court. First, I examine whether criminal records and the availability of legal representation for immigrants from Latin America and the Caribbean reduce the average probability of being released on bond. Second, I qualitatively assess legal cultures and practices in immigration court through the lived experiences of people undergoing proceedings, the organizational culture of the courts, and immigrant communities’ challenges and innovative defense strategies in these legal spaces.
I pose three interrelated questions. Are there unequal patterns in bond decisions? How do people with criminal records experience precarious legal protections in immigration court? Finally, how do attorneys confront the mark of the criminal record? Three sets of interrelated data are used through mixed methods strategies. First, I draw from the Executive Office for Immigration Review-EOIR Bond Case Data (1991-2020). Second, I draw from over 100 hours of remote (via Webex) and in-person ethnographic observation of four federal Immigration courts. Finally, semi-structured interviews approach immigrants and intermediaries, sharing strategies for navigating the crimmigration nexus.
I provide substantiation of biased decision-making, problematizing judicial discretion in a context where civil detention is unfairly applied. Latin America and Caribbean nationals are more likely to be denied bond, being disproportionately held in civil detention, regardless of whether they have a criminal history. This inequality is worsened in cases without legal representation. The mutability, adaptation, and extension of criminal records in immigration law display a space of inequality and racialization shaped by the bureaucratic structures in place. Qualitative data shows how judges exchange information with respondents from the initial stages of proceedings. In the absence of attorneys in those early stages, the construction of a racial migrant subject is concomitant to multiple repertoires of legal violence experienced by respondents. Attorneys in non-profit organizations acknowledge the challenges that the immigration system poses and how the overexposure of these communities to the criminal system knits together a political project of surveillance, stigmatization, detention, and likely deportation. Thus, their consciousness of the law is a motivation to confront it.Ph.D.Includes bibliographical reference
Evolution of ocean oxygen deficient zones during the Miocene: insights from and for the I/Ca paleo-oxygenation proxy
No full textIn recent decades, the oceans have been losing oxygen at a rate of >~2% per decade, with the largest effect in already low oxygen shallow-water areas called oxygen deficient zones (ODZs). This threatens marine ecosystems, including fish that billions of people rely on for food and economic stability. Understanding how ocean oxygenation will change with continued climate change is therefore vital. Models agree that deoxygenation will continue to at least the year 2100, but beyond this have not reached a consensus. By reconstructing ocean oxygenation in the past, particularly during warm periods analogous to our future climate, we can help resolve this discrepancy.
Chapter 1 of this dissertation (Zhou, Hess et al., 2022) develops a methodology for measuring iodine-to-calcium (I/Ca) in foraminifera along with other trace elements used for paleoceanographic research (e.g., Mg/Ca as a proxy for ocean temperatures). The I/Ca ratio in planktonic foraminifera, micro-organisms that live in the water column and create carbonate hard parts that are preserved in the fossil record, responds to oxygen concentrations in the upper water column. Because iodine is volatile, it has traditionally been measured in solutions with basic pH, where it is more stable. However, this means that it must be measured separately from other trace elements, limiting its utility. This chapter tests the feasibility of measuring I/Ca in acidic solutions using experiments on a standard solution with known elemental composition, in a carbonate coral standard widely measured during I/Ca analyses, and in planktonic foraminifera. Results show that with proper handling iodine is not lost from solution over the course of a typical 8-hour run, that I/Ca values in the coral standard are similar when measured in acidic and basic solutions, and that I/Ca in foraminifera follow trends observed in data measured in basic solutions. Thus, we conclude that I/Ca can be measured alongside other trace elements in acidic solutions, broadening the applicability of this proxy and opening the door for further proxy development via comparison with other paleoceanographic data.
Chapter 2 examines relationship between I/Ca ratios in core-top planktonic foraminifera and iodate and oxygen concentrations in the overlying water column. In samples from an east-west transect of sites through the southern lobe of the ETP ODZ (S-ETP ODZ), I/Ca values are higher than expected for sites with relatively low minimum oxygen concentrations (<100 µmol/kg), with some I/Ca values exceeding 4 µmol/mol. This can be explained by higher iodate concentrations in this lobe of the ODZ than in the northern lobe and in the Arabian Sea. We therefore urge caution in applying a global calibration, particularly in the S-ETP. However, lower I/Ca values in the core of the ODZ suggests that the proxy is still a good indicator of relative oxygenation. The relatively short distance (≤~600 n mi) over which iodate, oxygenation, and I/Ca shifts occur in this area suggest that caution should be taken when interpreting paleoceanographic records where sites have moved tectonically towards or away from the heart of an ODZ. We also find that I/Ca values in species from different water depth habitats vary predictably based on patterns in iodate concentration spatially and with depth in the upper water column, possibly providing another line of evidence for identifying the core of an ODZ in paleoceanographic records. Finally, sites from areas with intermediate oxygen concentrations (~100-170 µmol/kg), plotted alongside all existing core top I/Ca data, suggest that I/Ca may correlate linearly with minimum water column oxygenation, rather than by thresholds as previously suggested.
Chapter 3 (Hess et al., 2023) examines the response of oxygenation in the eastern tropical Pacific (ETP), today one of the largest and strongest ODZs in the world, to the Miocene Climatic Optimum (MCO; ~17.0-14.8 Ma), when temperatures and atmospheric pCO2 were similar to projections beyond the year 2100. Relatively high I/Ca ratios (>4 µmol/mol) during the MCO at Site 845 suggest that the northern lobe of this ODZ was well oxygenated at that time, with minimum oxygen concentrations in the water column exceeding 100 µmol/kg. During the subsequent cooling, falling I/Ca beginning at ~15.1 Ma and rising nitrogen isotopes in foraminifera beginning at ~14.6 Ma indicate deoxygenation and denitrification, which suggests oxygen concentrations below 5 µmol/kg. We hypothesize that MCO oxygenation was caused by decreased Walker Circulation, the prevailing equatorial zonal wind cell, and resultant decreased upwelling and productivity in the ETP, leading to less drawdown of oxygen by remineralizing organic matter. Sea-surface temperature gradients both zonally and meridionally were lower during the MCO, suggesting weaker wind fields at that time, including Walker Circulation. As Walker Circulation today drives upwelling in the ETP, this likely led to weaker upwelling and ultimately oxygenation of the ETP. To the extent that the MCO can be taken as an analog for future climate change, this suggests that recent deoxygenation trends may ultimately reverse.
Chapter 4 examines the oxygenation response of the Arabian Sea to Miocene climate change. Today, this area is another major ODZ, the result of upwelling caused by the Asian monsoon. In contrast to the I/Ca shift observed in the ETP in Chapter 3, Arabian Sea I/Ca ratios at Sites 730 and 714 are relatively low (<2.5 µmol/mol) throughout the ~20-8 Ma study period, suggesting that oxygen concentrations were <100 µmol/kg throughout that time. Based on records of redox-sensitive elements (Mn) and nitrogen isotopes in bulk sediments previous researchers have shown deoxygenation beginning at ~15 Ma. This coincides with increasing monsoonal activity also beginning at ~15 Ma. Here, we present new records from distal-ODZ Site 714 in the Maldives that suggest progressive expansion of the ODZ: at ~13.8 Ma, Mn/Ca falls and U/Ca increases in planktonic foraminiferal authigenic coatings, which indicating decreasing bottom water oxygenation, and nitrogen isotopes in bulk sediment samples begin to rise, indicating increasing denitrification. Considering these lines of evidence, we suggest that a proto-ODZ with oxygen concentrations <100 µmol/kg existed since at least 20 Ma, consistent with reports of a proto-monsoon since 23 Ma, then expanded and deoxygenated beginning at ~15 Ma in response to monsoonal intensification. The persistence of the Arabian Sea ODZ throughout the MCO implies a role for regional processes, such as the Asian monsoon, and the coincident deoxygenation beginning at ~15 Ma in the ETP and Arabian Sea suggests a teleconnection between the two basins and a role for global processes.
In total, this dissertation expands the utility of the I/Ca proxy by providing a methodology for measuring it alongside other trace elemental ratios. It reveals nuances of the proxy, suggesting that the relationship between I/Ca and oxygenation may be linear and showing that the relationship between I/Ca in species occupying different water depth habitats can give insights into the location of ODZs. It also identifies areas where caution should be taken in its application, particularly areas with anomalous iodate concentrations relative to oxygenation, areas with highly spatially variable oxygenation at oxygen concentrations near 100 µmol/kg, at sites that may have moved towards or away from an ODZ through the study period, and in certain species of foraminifera (Globoquadrina conglomerata, which has anomalously high I/Ca values for its water depth habitat, and Globorotalia tumida, which has low I/Ca values even outside of ODZs). Finally, the proxy has been used alongside other paleoceanographic proxies to reconstruct the response of two major ODZs to Miocene climate change, showing that both global and regional processes play a role in ODZ response to climatic warming.Ph.D.Includes bibliographical reference
Reconstructing the kinematics of gravitationally lensed dusty star-forming galaxies
No full textHigh-redshift dusty star-forming galaxies (DSFGs) represent a population of galaxies with some of the highest observed star formation rates in the Universe, but understanding the physical processes that lead to their evolutionary state has been theoretically challenging. Further observations of larger samples of these sources at higher resolutions and higher sensitivities, as well as with resolved kinematics that provide additional information about their physical state, will allow us to better constrain their properties. Gravitational lensing, which stretches and multiply images a background source, provides a unique opportunity to study high-redshift galaxies in more detail than would otherwise be possible. Reconstructing the undistorted source from observations of a gravitationally-lensed system allows us to recover the intrinsic source light distribution, while reconstruction of integral field spectroscopy allows us to study in even more detail the full kinematics of the source. In this thesis, I first present studies of two lensed DSFGs observed at high resolution with the Northern Extended Millimeter Array (NOEMA), using source reconstructions to study their intrinsic properties. These sources are the first of a large sample of Herschel-selected lensed DSFGs from the z-GAL survey that are now being observed at high resolution. I then present a novel method for reconstructing the kinematics of lensed sources observed with integral field spectroscopy, relying on regularization in three dimensions that improves on existing approaches. I explore the properties of the resulting reconstructions using simulated observations, finding that the recovered sources are less sensitive to the channel S/N ratio and produce a higher effective resolution in the source plane compared to previous approaches. Finally, I apply this new method to a set of archival Atacama Large Millimeter/submillimeter Array (ALMA) observations of lensed sources, to explore the effects of the new method on real observations. I discuss the implications of this exercise for our ability to assess the merits of different regularization schemes in combination with imperfect lens models.Ph.D.Includes bibliographical reference
Tracing the origins of the Holdeman Church: the formation of a conservative Mennonite religion
No full textThis study traces the historical origins of the Church of God in Christ, Mennonite (CGCM), informally the Holdeman Church, a group whose forbears were among the early Anabaptists in the Dutch Lowlands. To understand how the CGCM was formed in the nineteenth century United States and persists into the twenty-first century, the frameworks of social formation and revitalization are used to identify and describe the structures and processes that led to the creation of the Holdeman Church.
In the Protestant Reformation of the sixteenth century, the Anabaptists emerged as a radical group, advocating adult baptism and separation from the world. Three conservative religious groups resulted from the Anabaptist movement and today are known as the Amish, the Hutterites, and the Mennonites. Early in the sixteenth century, a man named Menno Simons applied his leadership talents to help coalesce the various Anabaptist groups in the Netherlands into what became known as the Mennonites. A few hundred years later, we find Elder John Holdeman spreading the Gospel in the rural Great Plains of America, demonstrating a remarkable likeness in worldview and belief to Menno Simons.
What is the relevance of the Anabaptist movement of the sixteenth century with the Mennonites in the nineteenth century United States? If we turn our attention to the small group of Mennonites led by Holdeman, known informally as the Holdeman Church, we will see striking similarities in doctrine and practice that were evident in Simons’ people of the sixteenth century Dutch Lowlands. Based on this observation, this study demonstrates the profound continuities that link the Holdeman Church, formed in mid- nineteenth century America, to the various groups that coalesced under Simons’ leadership and who were the first to be called "Mennonite."
Although Holdeman’s worldview was clearly anchored to Menno Simons and the Anabaptism of the sixteenth century, he benefited from a burst of religious revivalism in the early nineteenth century U.S. In this cultural ferment, lay preachers hoped to bring evangelical conversion to ordinary people. These religious leaders derived their authority not from education or stature, but rather from the art of persuasion. This energy contributed to the formation of a variety of new religious groups, teachings, and practices. Holdeman was likely emboldened by this religious activism, leading him to strike out on his own to create a new church. While the church has adhered to Anabaptist traditions, the CGCM has also adapted to modern American culture, acknowledging that change will continue to be a part of Holdeman life.M.A.Includes bibliographical reference
Temporal analysis of vulnerability during nesting season of northern pine snakes (Pituophis melanoleucus melanoleucus) in New Jersey
No full textUnderstanding the costs of reproduction for female reptiles is an important aspect of their survival and fitness. Detailed behavioral studies on nesting snakes are rarely observed in the wild. Because they are cryptic and rare in New Jersey, the Northern Pine Snake (Pituophis melanoleucus melanoleucus) is a state threatened species residing in the pine barrens and is vulnerable to human threats such as habitat loss, off-road vehicles, poaching, predators, and urbanization. This species is especially vulnerable during their nesting season and this paper is the first detailed study of Pine snake nesting by using time-lapse photography. This method is relatively new for monitoring squamates as time-lapse has been primarily used for avian and mammal species. It greatly reduces observer bias without affecting the snakes’ behavior, thus allowing for a temporal analysis of 10 individual female snakes at nest sites from 2017 to 2020. Vulnerability of the snakes was measured by recording duration of visibility above ground while duration of underground activity and presence was recorded by noting entry and exit of the nest. Two types of snakes (nesting and visiting) were classified, and 6 behaviors were defined. While nesting snakes can range from 223 to 906 minutes of above ground visibility a season, visiting snakes were visible 33 to 77 minutes within a season. Nesting snakes spend upwards to 8 days at a nest location, suggesting there should be more attention to protecting nesting females from human disturbance. Using high photo capture frequency of 2-seconds and proximity of the camera to the nest hole allowed observation of apparent behavioral and size differences between individuals. It is a possibility that larger nesting snakes were more likely to excavate nests quickly compared to smaller nesting snakes likely due to increased musculature. In which, these larger snakes could possibly be older and more experienced in locating nests from past years, whereas smaller nesting snakes are possibly younger and have difficulty finding a nest location consistently. Future studies should consider behavioral differences of nesting females based on age and size.M.S.Includes bibliographical reference
A unifying theoretical and empirical framework to study disorders of the nervous systems from molecules to complex social behaviors
No full textMultiple fields that research disorders of the nervous systems focus exclusively on the brain and guide their genomics quest by subjective clinical criteria. While this approach gives rise to highly heterogeneous disorders, it has also created a type of circularity that prevents more properly stratifying and understanding such disorders in ways that enable the development of specific targets for treatments that are guided by their neurophysiological underpinnings.
In this thesis I propose new standardized personalized methods under a unifying framework that incorporates the bottom-up contributions of the peripheral nervous systems to the top-down central nervous system control. To instantiate the new methods, I leverage the wearable-sensors revolution and deliver examples that aim at bridging behavioral neuroscience and genomics. These methods suggest new ways to improve diagnosis and treatments of nervous systems disorders by adopting non-linear dynamic approaches in agreement with the non-stationary, multi-distributional nature of empirical data spanning from behavior to genomics.
Throughout the thesis, I address neurodevelopmental and neurodegenerative neurological disorders as well as neuropsychiatric disorders, all of which manifest variable impairments in socio-motor agency. Here socio-motor agency is then defined as a balance between autonomy and control, whereby I provide precise indexes of autonomy and control that enable the moment-by-moment objective quantification, tracking and alteration of socio-motor agency in the person. I then extend this model to the human dyad as the fundamental unit of social group interactions. I describe various applications amenable to use in explainable AI and provide examples of scalable translational science for use in the home, the clinical and the school settings.Ph.D.Includes bibliographical reference
Perceptions, experiences and symptoms of mental health conditions of governmental public health workers in New Jersey post COVID-19 pandemic
No full textThe public health workforce in the United States, including New Jersey, has worked tirelessly over the last three years in response to the COVID-19 pandemic. Much like the general public, members of the public health workforce have reported increased feelings of stress, anxiety, and burnout during this time period. Nationally, there have been studies conducted during the course of the COVID-19 pandemic to collect demographic, competency, and self-reported mental health status data in regard to anxiety, depression, and burnout; however, most of the members of the governmental public health workforce in New Jersey (NJ) were not part of these assessments. To gain a better understanding of the demographic, mental health status, and opinions on the effect of the pandemic response of the local New Jersey governmental public health workforce, a survey was conducted. The final survey included questions from the Public Health Workforce Interest and Needs Survey (PH WINS), the Generalized Anxiety Disorder (GAD-7) assessment, the Patient Health Questionnaire (PHQ-9) and the Oldenburg Burnout Inventory (OBI) within the Jobs Demands-Resource theoretical framework.
The survey responses provide a clearer picture of the NJ governmental public health workforce demographically, by tenure, and reported workforce development needs with responses from 204 individuals representing 20 of the 21 counties in New Jersey. The survey respondents were predominantly white females between the ages of 25 and 60 years old. NJ’s governmental public health workforce is much smaller than those across the country and a majority of respondents serve larger communities with less staff than their national counterparts. There is also a distinct gap in tenure with the majority of respondents working either less than five or more than twenty years in the field. Additionally, respondents are more highly educated than the national average and many have degrees specific to public health.
The survey results demonstrated that the New Jersey governmental public health workforce’s self-reported mental health conditions were affected by a variety of factors including job satisfaction, organizational satisfaction, bullying and harassment, and supportive supervisors and leadership. Nearly 25% of respondents rated their mental/emotional well-being as fair or poor with about 20% reporting symptoms consistent with anxiety, depression, or burnout. Exhaustion, one of two conditions shown to contribute to burnout, was reported by 88% of the respondents.
The data indicate that New Jersey governmental public health workers experienced an increase in symptoms related to anxiety, depression, and burnout post-pandemic. These symptoms were correlated with survey respondents’ self-reported assessment of the quality of their work-related conditions. Recommendations for future research include conducting focus groups and key informant interviews to further explore factors impacting conditions. Recommendations made based upon the analysis of data as opportunities for improvement spanned across four distinct areas funding, training, mental health, and policy development.Dr.P.H.Includes bibliographical reference